Individual ProviderAriel Carissa Hermes DaughertySocial WorkerBehavioral Health & Social Service ProvidersPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371(503) 234-9591PECOS EnrollmentBased on the most recent information from CMS, provider Ariel Carissa Hermes Daugherty does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1205351202Provider TypeIndividualFull NameDaugherty, Ariel Carissa HermesCredentialQMHA, MSWGenderFemaleSole ProprietorNoEnumeration Date8/10/2017Last Updated5/14/2021Contact InformationPractice LocationPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371Phone(503) 234-9591FaxUnlisted FaxMailing LocationMailing Address3415 SE Powell Blvd, Portland, OR 97202-3371Phone(503) 234-9591FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerOregon